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Slow prepubertal linear growth but early pubertal growth spurt in patients with shunted hydrocephalus
T Löppönen1, A L Saukkonen, W Serlo
1Department of Pediatrics, University of Oulu, Finland.
Insights
Children with hydrocephalus show slower growth before puberty but an earlier adolescent growth spurt, resulting in reduced final height. Obesity prevalence increases, particularly after puberty.
Area of Science:
- Pediatric endocrinology
- Growth and development
- Neurology
Background:
- Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
- Shunting is a common treatment to manage hydrocephalus, but its long-term effects on growth require evaluation.
Purpose of the Study:
- To assess growth patterns in children with shunted hydrocephalus.
- To compare anthropometric measures and physical maturation with healthy children.
Main Methods:
- Growth data, auxology, puberty stage, and bone age were analyzed.
- 114 patients (5-20 years) with shunted hydrocephalus were compared to 73 healthy controls.
Main Results:
- Children with hydrocephalus exhibited slower linear growth in prepuberty and reduced final height.
- An earlier pubertal growth spurt was observed in both boys and girls with hydrocephalus.
- Increased obesity prevalence was noted, especially in girls and post-pubertal patients.
Conclusions:
- Shunted hydrocephalus impacts linear growth, leading to reduced final height despite an earlier pubertal growth spurt.
- Children with hydrocephalus are at higher risk of obesity, necessitating monitoring and intervention.
Objective:
To evaluate growth and to compare anthropometric measures and the degree of physical maturation in children with shunted hydrocephalus with those in healthy children.
Methods:
One hundred fourteen patients (62 male) and 73 healthy subjects (38 male) 5 to 20 years of age were analyzed for growth data and current auxology, stage of puberty, and bone age.
Results:
Boys with hydrocephalus were shorter than control boys during their first 8 years of age, and no catch-up growth was observed until puberty. Girls with hydrocephalus were of the same size at birth as the control girls, but their linear growth retarded during the first years of life, leading to reduced relative height between the age of 5 to 8 years. The pubertal growth spurt occurred earlier in boys with hydrocephalus (age at midgrowth spurt, 12.1 vs 13.3 years), and a similar trend was seen in girls (10.0 vs 10.7 years). The final height was again reduced, especially in boys. Patients with hydrocephalus were more obese than control subjects, girls more often than boys. Relative bone age was retarded in prepubertal (-0.42 vs 0.32 SD) and accelerated in pubertal patients (0.54 vs -0.19 SD).
Conclusions:
Children with hydrocephalus experience slow linear growth in prepuberty, but they have an earlier adolescent growth spurt. Together these factors result in a reduced final height. An increase in relative weight emerges in the preadolescent period, and this phenomenon is accentuated after puberty, leading to an increased prevalence of obesity.